Borg: Cardiovascular diseases should be higher on the political agenda

Cardiovascular disease is the number one killer in the EU, but it is not yet given enough importance on the political agenda, according to Tonio Borg, who has scheduled an EU summit on chronic diseases at the beginning of next year.

Tonio Borg is the EU commissioner for health. He spoke to EURACTIV's Henriette Jacobsen and Evan Lamos at the launch of the Cardiovascular Health Week, an initiative by the MEP Heart Group.

This evening was about awareness about a healthy heart, considering that cardiovascular disease is still the number one cause of deaths within the EU, but basically also because we are not a EU on this matter.

There are too many divergences, too many inequalities in the statistics, in the percentages and in the prevention as well. On average, EU member states only spend 3% on prevention. We have to improve that figure. This remains the responsibility of the member states, but the Commission has a role to play in encouraging member states to use more money on prevention and also in coordinating the strategies of the different member states on the question of cardiovascular disease. Why? Because cardiovascular diseases are preventable so we can reduce the numbers. The numbers have already been reduced but more has to be done. I welcome this because this is a challenge, not only within the Commission, but also for the member states.

What is the best role for the EU in order to make progress in this area?

We have taken a lot of steps through joint actions, but also through financing programs in the member states. But I think it should occupy a more important position on the political agenda.

So I have announced today that in Spring next year, we will be organising a summit in Brussels so that we get the governments, the NGOs, the stakeholders, the academic world together to focus on chronic diseases in general, but cardiovascular diseases are the most common cause of deaths so that will occupy an important position in the summit. Not just to organise another summit and then everybody will forget what we have discussed, but to come out with recommendations and to see which actions can have a valued-added measure through EU intervention. We don't want to intervene just for the fun of intervening.

In health, there is a strong dimension of solidarity, but we want to intervene where the EU can make a difference. We feel that in certain areas it can make a difference, so let's discuss those actions, those measures which we can take with the member states where the EU can really make a difference.

From a citizen's perspective, what do you think is the key challenge?

We can't fight cardiovascular diseases only with the academic dimensions or only with members of the academic world or the stakeholders only. We need the support of the citizens themselves. Only with the participation of citizens, would we be able to fight cardiovascular disesases effectively which is why also NGOs and the representatives of patients will be invited to the summit as well.

The number of obese children in Greece has increased during the financial crisis. Therefore the crisis must be putting more of us at risk of getting cardiovascular disease. Do you have an advice for those member states that have been hit particularly hard by the crisis?

Child obesity is not a problem of any particular country. I was in Ireland during the Irish Presidency where we discussed in particular child obesity. It is not also a direct result of the financial crisis. There are countries which are affluent, which have no financial problems, but the problem of obesity is great.

Of course there are different courses of obesity so we have to fight the obesity itself and its various causes and mostly because there are tendencies in the EU, but it is on the rise and it's causing a rise in diabetes figures in the age at which diabetes is contracted. These are the real problems of obesity: That you are creating problems for the future and not for the distant future, for the immediate future as well. So yes, there is an action plan on this matter regarding nutrition, there's not one single magic formular to solve the question, but there are different measures that can be taken which we have discussed in this working group and action plan on obesity.

It's high on our agenda, not only verbally by saying it here in this interview, but in actual concrete action which has already been taken. We can't force member states to do what they should do, but we encourage them to do what it's possible for them to do in coordination with the European Commission.

Could you imagine in the future having a common EU strategy on cardiovascular health?

Now we are fighting chronic diseases by focusing on the factors rather than having a strategy for each chronic disease. the only chronic disease where we have a specific strategy is cancer. We are discussing whether we should create one on diabetes for example, but I cannot say that we are going to do it.

Until now, the general strategy has been to fight the risk factors in general and not a specific disease, but I do not exclude that if the current trends continue, we could have a strategy just for cardiovascular disease.

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The United Nations is ready to play central role for all countries; including those with low incomes across the world, to achieve greater health equity and protect future generations by encouraging Member States to plan, pursue, transition of national health care systems towards universal coverage. However, it is not clear, how food security would be achieved in the Third World countries in a way that they do not suffer the epidemic of NCDs during transition from poverty to affluence. The challenge would be, how to develop “Functional Food Security” and inexpensive spare time and occupational physical activity across the whole, ‘no tobacco’, world for prevention of NCDs.

INTERNATIONAL COLLEGE OF CARDIOLOGY (ICC)
The ICC reiterate the above mentioned efforts and challenges, which may not be the final, because primarily, we should target health behaviour and health education about prevention to address all the 4 components of total health as emphasized by the International College of Cardiology and International College of Nutrition . This includes prevention of deaths due to injury as well as improvement in social, mental and spiritual health which appear to be least known to people and experts in the West. Various social markers of health and wealth can influence the levels of health behaviour; physical inactivity, dietary patterns, salt intake, alcohol consumption and tobacco use and stress which are important in the pathogenesis of CVDs (Figure 2, Table 2). Big food and big systems have become common in wealthy countries which are being followed in the developing countries resulting in to increased risk of CVDs (16,26). Effective control of NCDs requires a comprehensive approach. There is a need to collaborate the department of agriculture, food and nutrition, department of education and department of sports and transport and housing in every country to make a health promotion policy so that students right from play schools to postgraduate colleges as well as citizens working in offices or factories, can have the opportunity to get slowly absorbed, micronutrient dense, w-3 fatty acid rich, ready prepared functional foods, cola drinks/fruit juice as well as fresh foods and spare time physical activity at affordable cost. A public health policy providing tax relief to food industry, farmers growing health foods (fruits, vegetables, seeds and nuts and herbs), food departmental stores and public/private health promotion centers; gymnasiums, yoga and meditation centers, parks and foot paths for cycling and walking may be great steps in a no tobacco world for prevention of NCDs. There is a need to develop more concentrated flavonoid rich wines, like Chinese wines, to avoid the use of alcohol rich sprits. These efforts should be started also in the Third World and lower middle income countries, apart from the developed countries.